Is that normal? Bowel Function Edition

oday we are continuing the theme with another very popular topic in pelvic floor physical therapy patient appointments: bowel function. What’s normal? What’s common, but not normal? And, what’s a cause for concern? We are going to answer all three of those questions for you right now. 💩

Three Habits for Healthy Bowels

Hydration: Drink approximately half of your body weight in ounces of water every day. If you struggle to get enough water, try adding flavor with fresh fruit, mint, or flavoring drops for a soda stream machine. It makes a huge difference!

Fiber: The average adult needs about 30 grams of fiber a day, and most of us come up very short of that. Whole foods like beans, broccoli, berries, and whole grain breads are our preferred way of fiber intake, but if that feels too difficult you can also use fiber supplement like Metamucil or have a Fiber One bar for a snack.

Movement: As we always say, movement is medicine! Going for a daily walk, doing some simple yoga poses that focus on your abdominal area, or doing any gentle movement that includes your core will help you stay regular.

What's Normal:

Frequency: Ideal frequency for bowel movements is one to three times per day. Everyone's a little different when it comes to timing, but your Gastrocolic Reflex will typically give you the urge to empty your bowels about 30 minutes after you eat a full meal.

Form: Your stool should appear similar to a 3 or 4 on the Bristol Stool Chart. That is, relatively uniform and sausage-shaped, firm but not hard, with a smooth or slightly cracked surface and expelled in just a few longer, unbroken pieces.

 

Effort: Your bowels should empty themselves with minimal effort once you’re seated on the toilet without straining hard or bearing down. If it doesn’t come right out, a gentle push as you exhale should be all that’s needed. A healthy bowel movement should take no more than 10 minutes, and usually much less. (If your partner spends 30 minutes in the bathroom every time they go to poop, please tell them to come see us).

What's NOT Normal:

Going several days without a bowel movement: After one or two days, you’re likely just constipated and need to add water, fiber, and movement to your routine. You can also try a stool softener to get things moving, especially if you’ve had changes in your diet recently. If you experience 4+ days without a bowel movement, consider seeing your physician to make sure there’s not something else going on.

Consistently loose or runny stool: If you’re running to the bathroom frequently and it looks like levels 5, 6, or 7 on the Bristol Stool Chart, your body is likely not getting the nutrition it needs. You’re also losing a lot of water. We recommend seeing your physician for this one, too (especially if you’re at a Level 7 for more than 12 hours).

On a very tender note, diet culture is real and extremely difficult to navigate. There is never ANY shame in struggling with that, but there is also help and healing available. If you are experimenting with any extreme diets or weight loss supplements and you relate to the types of bowel movements we’re discussing in this section, please be kind to yourself and seek professional help from a doctor or a therapist. You are worthy of love exactly the way you are.

Regularly seeing undigested food in your stool: Some foods (like corn) just don’t digest well. Seeing recognizable pieces of food in your stool isn’t immediate cause for alarm. But, if you notice certain things showing up every time you eat them, you might consider removing those culprits from your diet. Your body is struggling to break those down and it could result in uncomfortable side effects like bloating and acid reflux.

Spending more than 10 minutes on the toilet or bearing down: If you are spending a considerable amount of time on the toilet before anything comes out, you may be going to the toilet before your bowels are ready. This might simply mean you’re bloated or ate a little too much volume for comfort at your last meal. Try taking some Gas-X and do your best to listen to your body’s hunger and satiety cues when eating. Bearing down can also create and exacerbate hemorrhoids (ouch!)

Sitting down and immediately experiencing explosion without any effort: This can happen occasionally, but constantly struggling to control your bowels is likely related to a much larger dietary or overall health issue. If this becomes your normal, it may be time to consult with a nutritionist to get to the bottom of the problem

Excessive wiping: Believe it or not, you should only have to wipe two to three times before you're clean. If you have to wipe several times before there's no evidence of poop left behind, that means something is preventing your body from pushing your stool all the way out. It could be weak sphincter muscles, hemorrhoids, scar tissue, constipation, or something else causing the problem.

Final Tips For Healthy Bowels

Elevate your feet: We will continue giving squatty potties as gifts until we are dirt in the ground. Putting your feet up on a squatty potty, an overturned wastebasket, a laundry basket, or whatever you have on hand, allows your body to assume the proper posture for elimination and makes things so much easier.

Give yourself a bowel massage: If you’re feeling constipated or struggling with level 1 or 2 on the Bristol Stool Chart, we love a good bowel massage. Use light pressure on your abdomen and trace the pattern we demonstrate in the linked Instagram video. It feels like a nice little self-care moment and it helps with gas relief and constipation.

Make sure you’re eating enough food: In frequent poops can be a sign that you’re not eating the volume you need to eat for a healthy digestive system! What you eat matters, but so does making sure you eat enough.

Get help if you need it: Please don’t ever be embarrassed to talk to a doctor about poop - we know society has made it feel gross and taboo, but it really is one of the best indicators of health and we all do it!

Looking for a pelvic floor physical therapist in Kansas City to navigate healthy bowels? We would love to meet you! Schedule a free consultation with one of our Well + Core physical therapists today.